Pelicano Module 2 Cardiovascular Flashcards by Kailash Jagessar

Hypertension

Defined as B/P higher than 140/90. Physical inactivity causes blood to be stagnant and allow gunk build up. stress raises B/P, and can cause vasoconstriction.

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Risk factors in Circulatory/Heart Diseases

Age, Gender, Ethnicity, Heredity, Smoking, Obesity, Physical Inactivity, Hypertension, Hyperlipidemia, Diabetes Mellitus, Stress, Metabolic Syndrome.

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Classification of BP and stages of Hypertension

Normal = 120/80
Prehypertension = 120-139 / 80/89
Stage 1 = 140-159 / 90-99
Stage 2 = 160 + / 100 +

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Common symptoms of Hypertension

Nose bleed. Headache. Damaged blood vessels

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Treatment for hypertension

Lose weight, limit alcohol, stop smoking, LOW SODIUM DIET, exercise, always monitor B/P

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Atherosclerosis

Yellowish plaques of cholesterol, lipids & cellular debris (from smoking), in the inner layers of the walls of the arteries. Lumen of the vessel narrows causing obstruction of blood flow.

Severity of disease is measured by degree of obstruction.

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Risk Factors of Atherosclerosis (Same as HTN)

Age, Gender, Ethnicity, Heredity, Smoking, Obesity, Physical Inactivity, Hypertension, Hyperlipidemia, Diabetes Mellitus, Stress, Metabolic Syndrome.

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Coronary Heart Disease

Conditions that obstruct blood flow in the coronary arteries (supply blood to the heart).

Primary cause is atherosclerosis.

When flow of blood & oxygen is cut off cells will die.

Most common diseases resulting from this are angina & myocardial infarction.

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Angina

Chest pain

The heart is screaming out in pain.

This is a warning that there is not enough oxygen

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Angina Pectoris

Atherosclerosis of the coronary arteries is the most common cause (90%) can also be caused by a thromboemolism.

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Cause of Angina Pectoris

decreased flow of blood to the myocardium (ischemia) leading to oxygen and chest pain(angina)

triggered by cold, exercise. (activity increases metabolic demand) & stress

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Signs and Symptoms of Angina Pectoris

PAIN, heaviness or tightness in substernal area of chest or precordial(across the heart), spasmostic(fluctuating) severe discomfort

Pain starts to radiate to neck, arms, shoulders, or jaw

SOB, pallor, anxiety & fear

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How to relieve pain of Angina Pectoris

Rest and Nitroglycerin. (Vasodilator)

Can take nitroglycerin every 5 min x 3 if pain doesn’t go away go to the hospital

Beta Blockers / Calcium channel blockers (after diagnosed)

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Medical Procedures used to treat Coronary Artery constriction

CABG ( Coronary Artery Bypass Graft )

PTCA (Porcutaneous Transliminal Coronary Angioplasty) Balloon

Coronary Artery Stent ( Wire mesh that is expandable keeping artery open )

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Nursing Care for Angina

Assess chest pain, VS, O2 saturation, cardiac monitoring.

Semi-fowlers with O2 therapy as ordered

Administer medications - Check B/P and HR

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Myocardial Infarction

permanent lack of oxygen , ischemia (large area) , Necrosis ( smaller part)

Occlusion of one of the coronary arteries or its branches by clot or sclerotic condition; the part of the heat that loses the blood supply dis (necrosis of the area)

Mi usually affects the left ventricle because it is the workhorse of the heart & demands more oxygen

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Signs and Symptoms of Myocardial Infarction

May be asymptomatic : silent MI

Pain - substernal or precordial - more severe than angina, crushing, vise - like, radiates to shoulder, arm, neck, jaw, prolonged, intense. Not relived by rest or Nitroglycerin

SOB, pallor cold/clammy skin, diaphoresis, anxiety, nausea/vomiting, decreased B/P, tachycardia, weak pulse, increased temp.

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Valsaluer Maneuver

Bear down - need to prevent to patient from doing this. Making sure stool is soft

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Nursing care for Myocardial Infarction

Medications, Morphine (decreases pain)
Heparin
Angioplatelet agents ASA
Stool softeners
Avoid fatigue, O2 therapy, Decreased fat/NA
ANTI EMBOLISM Stockings (prevent clot formation)

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Rheumatic heart disease

Results from inflammation of the heart. Zithromax used often

Caused by inadequately treated strep infection

inflammation of cardiac tissue, CNS, joints, and skin

Causes necrosis on valve

Develops vegetative growth

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Signs and Symptoms of Rheumatic Heart disease

Fever, joint and abdominal pain, chest pain/discomfort. Tachycardia/SOB, lethargy and fatigue, Valve problem MAY HEAR SWISHING SOUND (murmur)

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Treatment of Rheumatic Heart disease

Rapid treatment of strep infection

bedrest when accurately ill (carditis present) - gradually increase activity

Manage joint pain use NSAIDS decreases inflammation of the heart

MAY NEED VALVE REPLACEMENT IF DAMAGE

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Pericarditis

Inflammation of the membranous sac surrounding the heart.

Associated with bacterial, viral, and fungal infection.

NEED TO DECREASE INFLAMMATION

OUTER LAYER GETS INFLAMED

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S/S of Pericarditis

Chest pain radiating to back or neck may be aggravated by deep breathing, laying down, coughing, movement, swallowing or supine position. Pericardial friction rub, fever, chills, dyspnea, tachycardia, arrhythmia

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Treatment of Pericarditis

Analgesics, VS, O2, IVF, Anti inflammatories. Pericardiocenesis to remove fluid

Endocarditis

Inflammation or infection of inner membranous lining of heart, especially the valves (Vegetative emboli)

Myocarditis

Inflammation of the myocardium Caused by rheumatic heart disease. virus, or bacteria. May develop into cardiomyopathy

Cardio myopathy

Failure of the heart to PUMP Group of heart diseases that affects its structure and function. Causes are unknown - viral bacterial alcohol drugs radiation. MAY NEED A/CD AUTOMATIC CARDIAC DEFRIBULATOR

Valvular Heart disease

Valves do not open or close properly due to stenosis (thickening of valve tissue causing narrowing) or insufficiency. MAY NEED VALVE REPLACEMENT

Peripheral Vascular System

Arterial disorders ( disorders occur when circulation to upper & lower extremities is compromised) Arteriosclerosis and Athersclerosis of the peripheral arteries results in decreased blood supply; this is an underlying problem in this disease

PVP/PAD

Peripheral Vascular Disease / Peripheral Arterial Disease Usually effects lower extremities INTERMITTENT CLAUDICATION - pain with activity due to ischemia - described as aching or cramping

Arterial Aneurysm

Enlarged dilated portion of an artery. | Can occur in lower extremities, thoracic/abdominal aorta.

Buergers Disease

AKA Thromboangitis Obliterans occlusive vascular condition in which small/medium arteries become inflammed & thrombotic OCCURS IN SMOKERS MALE 25-40

Raynauds Disease

Intermittent arterial spasms/ischemia attacks especially fingers, ears, toes and nose. Affects more WOMEN 20-40 Cause unknown Chronic cold hands and feet. Cyanosis & pain may result in ulcerations

Venous Disorders

Occurs when blood flow is interrupted in returning from tissues to heart 'Thrombophlebitis / Varicose Veins

Slow heart rate, usually defined as fewer than 60 beats per minute

Bradycardia

Rapid heart rate, usually defined as greater than 100 beats per minute

Tachycardia

Abnormal thickening and hardening of the arterial walls caused by fat and fibrin deposits (plaques of cholesterol and lipids

Atherosclerosis

Obstruction of a blood vessel with a blood clot transported through the blood stream

Thromboembolism

A sound heard on auscultation; in the heart, it indicates turbulent blood flow across heart valves

Murmur

Abnormal thickening and hardening of the arterial walls ( thickening and lost of elasticity + calcification of arterial wall )

Arteriosclerosis

The amount of blood in the left ventricle at the end of diastole; the pressure generated at the end of the diastole

Preload (Stretch Ventricle)

Disturbance of rhythm, arrhythmia

Dysrhythmia

Study of the movement of blood and the forces that affect it

Hemodynamics

A heartbeat that is strong, rapid, or irregular, enough to have the person realize it

Palpitation

Fainting

Syncope

The amount of resistance the left ventricle must generate to open the aortic valve

Afterload (Must eject blood again)

Backward flow

Regurgitation

An area of ischemic necrosis caused by disruption of circulation

Infarct

Passage of blood through vessels of an organ

Perfusion

An ambulatory ECG that provides continuous monitoring

Holter Monitor

A transducer is used that picks up SOUND WAVES and converts them to electrical impulses

Echo-cardiogram

A high resolution, 3D image os the heart, cardiac tissue is imaged WITHOUT LUNG OR BONE INTERFACE

MRI

An exercise tolerance test that is a recording of an individuals cardiovascular response during a measured exercise challenge

Stress test

Study of electrical activity in the heart

ECG

A procedure in which a catheter is advanced into the heart chambers or coronary arteries under fluoroscopy

Cardiac catherization

Test that may determine pressures in the RA, RV, and pulmonary artery

Cardiac catherization

Electrodes place on the surface of the skin pick up the electrical impulses of the heart

ECG

The patient ambulates in a treadmill or stationary bicycle while connected to a monitor

Stress test

Heart sonogram that is a visualization and recording of the size, shape, position, and behavior of the hearts internal structure

Echo-cardiogram

A test that determines the body's ability to maintain the acid-base balance

Arterial blood gases

A test used to measure a blood lipid that is produced by liver and is used to form bile salts for the digestion of fats and to form some hormones

Cholesterol

In addition to LDL cholesterol, these lipids are a major contributor to coronary artery disease

Triglycerides

Feeling of impending doom

Anxiety

Lack of oxygen to the myocardium

Pain

Decreased Cardiac Output

dysrrhythmia

Dependent edema, Increased central venous pressure, Jugular vein distention, Abdominal engorgement are all examples of CHF in what side

Right side

Decreased B/P readings, Anxious, pale, and tachycardiac, Crackles, wheezes, dyspnea, and cough are all examples of CHF in what side

Left side

When the patient has right sided heart failure, there is a congestion of blood within the

Peripheral Vascular System

Cardiomegally

Enalrged heart

4 common symptoms of Heart failure

Cardiac output Peripheral Edema Ascites Lung congestion

(T/F) Drug therapy is aimed at improving cardiac output

True

(T/F) Pulmonary edema represents a medical emergency

True

(T/F) Pulmonary edema is a complication of left sided failure

True

TWO of the MAIN medications used to treat CHF

Digoxin | Lasix (Diuretic)

What type of diet is prescribed for a patient with CHF

LOW SODIUM, low fat

Orthopnea

Breathing is only capable when sitting up

Headaches and nose bleeds are the most common signs of

Hypertension

Decreases blood flow to the myocardium, causing decreased oxygen

Ischemia

Wire that expands to keep artery open

Coronary Artery Stent

"Balloon procedure, Angioplasty"

PTCA

Best position to put someone with Angina

Semi-fowlers

Where heart failure usually begins, DECREASED CARDIAC OUTPUT, shortness of breath, dyspnea, pink frothy sputum

Left ventricular failure

Affects liver, ascites, distended jugular veins

Right ventricular failure

When blood is a viscous red fluid that contains RBCs, WBCs, and platelets suspended in a light yellow fluid

Blood Dyscrasias

Decreased RBCs

Anemia

What does ascorbic acid and Vitamin C have to do with iron

Helps absorb the iron better

Decreased circulation blood because of a hemorrhage

Hypovolemic shock

Abnormal crescent shaped RBS

Sickle Cell

Immunological problem resulting in decreased bone marrow function

Aplastic Anemia

Severe reduction in # of total granulocytes

Agranulocytosis

Excess WBCs accumulate in bone marrow & lymph nodes, Not producing MATURE WBC

Leukemia

Most curable of all cancers, linked to Epstein-Carr virus, PRESENCE OF REED-STERNBERG CELLS

Hodgkins Disease

Pelicano Module 2 Cardiovascular Flashcards

(93 cards)